Mental health services in schools: the challenge of locating a psychotherapy service for troubled adolescent pupils in mainstream and special schools.

In Part 1, the case is presented for school-based mental health services in terms of the low utilization of community-based clinics and the high dropout rate among young adolescents attending clinics in the community. The advantages and potential pitfalls of school-based services are also assessed. In Part 2, the paper discusses the lessons learned from delivering psychotherapy services in mainstream and special schools to tackle the mental health problems presented by troubled pupils. The author describes the schools and discusses the expectations among teachers of the psychotherapist and psychologist. The role of the psychotherapist and psychologist in the schools is outlined. The types of treatment approach, the setting for treatment, method of referral, parental consent, and links with the wider network of adolescent mental health services and evaluation of outcome are considered. Finally, the author discusses the tensions that can arise between the psychotherapist and psychologist and school staff and ways of overcoming them.